Spondyloarthritis & psoriatic arthritis
The impact of first-line tumour necrosis factor inhibitor treatment on anti-infective use in patients with axial spondyloarthritis: a nationwide retrospective cohort study
Authors' conclusion
Filled AIPs among axSpA patients increased after TNFi initiation in contrast to what has been documented in prior studies on severe infections.
Study context
- Population
- Adult biologic-naive patients with axial spondyloarthritis (axSpA) initiating TNFi in 2003–2018, nationwide (ICEBIO), and matched general population individuals
- Participants
- 378 axSpA patients
- Exposure
- axSpA patients initiating first-line TNFi vs matched general population comparators; Anti-infective prescriptions (AIPs) 2 years before vs after TNFi initiation
- axSpAn = 378
- Outcome
- Incidence rate of anti-infective prescriptions (AIPs) per patient-year
- Follow-up
- Two years before and after TNFi initiation
Methodological detailsnationwide, matched cohort (on age, sex and calendar time to five individuals from the general population), multivariable analysis
- Nationwide
- Matched cohort (on age, sex and calendar time to five individuals from the general population)
- Multivariable analysis
Main finding
As reported in the abstract
AIP IR per patient-year before TNFi · before TNFi treatment
P < 0.001
Observational data: associations, not effects.
Further findings
Antibiotics incidence rates (IR) per py in axSpA, before vs after TNFi
- Increase from 1.04 (0.97-1.12) to 1.29 (1.21-1.38), p<0.001
Antivirals IR per py in axSpA, before vs after TNFi
- 0.03 (0.2-0.04) vs 0.07 (0.06-0.1), p<0.001
Factors associated with AIPs after TNFi initiation
- Prior AIPs, female sex and higher HAQ score associated with increased AIPs; age, smoking, GC or MTX use were not
Original publication
The impact of first-line tumour necrosis factor inhibitor treatment on anti-infective use in patients with axial spondyloarthritis: a nationwide retrospective cohort study. Clin Exp Rheumatol. Published 28 November 2024. doi:10.
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